Interview with International Psychosexual Therapist Dr. Sara Nasserzadeh. This interview is one in a series of expert interviews on the eDrugstore.com blog. We add new interviews on a regular basis. Please see our complete list of insightful interviews
1. How can couples who have been together for a long time reach past “going through the motions” and catapult into great sexual experiences?
Some couples in long-term relationships cannot even be bothered to go through the motions let alone having an exciting sex life, so first of all, bravo to whoever keeps the mechanics going at least! Now as how they can improve their sex life, there are many ways. The important factor that I always emphasis is to develop an effective and on going communication routine between them.
They have to expand their horizons. They can do this by for instance watching or reading erotic material (not necessarily porn), attend couple’s retreats if they can, travel to exotic places and explore things together as well as create common experiences. These then will be transferred in to their sex life too. Sex is a sensual, mutual experience therefore, the more pleasant experiences a couple have together in general the better and more harmonized their sex life would be.
The mistake many couples make is that they get comfortable within the relationship and might think that something that worked before would still work. This is a huge mistake. When I say develop an effective and on going communication routine I mean to keep learning about their own bodies as well as each other’s as they grow old together and share it with one another. Because not only will our bodies change over time but also the external factors that might influence ones sexual preferences will change as well.
Remember that the communication routine should not only be effective but also it should be ongoing because if for example after 15 years of marriage all of a sudden one person suggests something new, their partner might be alarmed that why they are asking for this change now! A suggestion is to commit to review your sex life (turn ons and offs, preferences, etc.) on each anniversary. This way you will not get into old and boring habits and no body will get offended if their partner shares their new preferences. If you are already in a long term relationship and have not done this so far the key is to start having non- judgmental and open communication with your partner. This will start by being non-judgmental yourself. I mean if your partner comes to you and wants to share a erotic thought with you, instead of being threatened and accusing them of having changed, basically try to learn more about it. This could actually help you to be a more skilled lover. She/he is giving you insider tips. Take it and use it!
2. What percentage of women rarely or never have an orgasm? Why is this? And what can be done about it?
According to the DSM-IV-TR this condition is called anorgasmia and this could be life long (the person never experiences orgasm) or acquired (the person was orgasmic but not anymore), Generalized (at all times) or situational (which means that the person is able to have orgasms but not at all times and under all circumstances). This could be due to psychological or combined factors (meaning the side effect of medication, relationship issues, lack of information about ones body, lack of skills from both sides, etc.) According to a large study in 2001, 7 to 10% of women reported inability to experience orgasm.
However, I have to say that as a psychosexual therapist I see women who complain about anorgasmia but after I take their full history I realize that they are in fact orgasmic but are not aware of it! This might be mainly due to their expectations which are built based on non-scientific data. For example: this is a myth that “once you have it you will know” or “ you should expect an explosion”. Especially for women who can have orgasm through different kind of stimulations each of which could result in different level of intensities. The key is to don’t focus on having or not having orgasms and just enjoy the experience. In our book Orgasm Answer Guide we went to detail to explain about anorgasmia on pp.5-7. Also in the book you can find answers to the most common questions about orgasm as well, including exercises you can do to enhance your orgasm.
3. How can couples learn to tune in to each other sexually, without feeling embarrassed or self-conscious?
This is a very important question and I would like to answer it addressing two groups of couples: a) Couples in new relationships moving towards establishing a long-term relationship and b) The ones already in a long term relationship
♦ When we first enter a new relationship we will be bringing our past experiences (if any), assumptions, insecurities and so on to this new relationship. A general assumption is that whatever that worked in the previous sexual relationship, will work in this new one too. While this might be true from certain aspects (e.g. listening to each other’s needs will result in better intimacy), it is not the case for everything. I have seen many couples who had a favorite sexual position in one relationship and got disappointed when it did not work as well in their next relationship. Therefore, the best advice I can give couples who are in a new relationship is to spend a few weeks to know each other, experience different settings (movie, restaurant, walking, meeting with friends, etc.) and then move on to the sexual part of the relationship. You first need to build up a trusting relationship so that you can talk to each other about your likes and dislikes when you get into bed. This is especially true for women who tend to be more shy and hold back from telling their partners what turns them on and off and then will end up dissatisfied.
♦ Now, let’s suppose that a couple met and established a reasonably satisfying sex life. Starting well is great but does not guarantee a life long sexual satisfaction. We all change over time, physically, emotionally and mentally. These all affect the way we view ourselves as sexual beings. Therefore, it is quite important to be honest all along the way and keep the communication open so that both of you can evolve within the couple relationship. Honesty here means that don’t say something when you don’t believe in it. For example, it is ok to fake an orgasm once in a while but if you do it all the time and after 11 years decide you don’t want to do this any more and suddenly you think: “hang on a minute I deserve a real orgasm” then I am afraid it will be too late. Most partners get this news as a sudden attack on their whole being. Thinking they have been cheated on.
Also have in mind that the most dangerous element in long term relationships is drifting apart. This could happen in various fronts (mainly because couples don’t spend quality time with one another) and before they know it they will end up living with a totally different person. This new person will have new sexual needs too which are not known to their partner. One suggestion is what I mentioned in Q 1, pick a date (such as your anniversary or even Valentine’s Day) and go through your wants and preferences with each other and establish a new sex life. In most cases your partner will be grateful for your initiative because they often have things to share with you but they did not know how! Please remember that even before getting to a sexual relationship with someone else it is very important that you know about your own body, sexual preferences and so on so that when you get to a couple’s relationship you can articulate them. For some people, I understand that you might not like exploring your sexual preferences while single, then you need to make sure that you are comfortable with your body so that you can explore and learn about your sexual preferences once you are in your desired relationship.
4. What would you tell 
couples to expect sexually once a new baby arrives into their life?
Sex life after the child birth is pretty much defined with how the couple’s sex life was before the baby was even conceived. Therefore, I would tell them that if you did not have a satisfying sex life before the birth of your child, you need to be even more determined, committed and communicate very well with one another to establish a new sex life which will be satisfying for the two of you. Childbirth is a bittersweet experience for many couples. Even if the child and mother are both healthy and happy. This is especially true for the first child. On one hand the couple who were used to two adults under one roof, have to deal with a third party who does not even speak the language! On the other, mother’s energy will be literary drained by the birth experience and caring for the newborn. Managing your time is the most essential factor to get you back on track with your not only sex life but your general relationship. Make sure you will have enough time for the two of you as a couple even if you have other children this is very important to leave time for the two of you to talk. Your time alone should not necessarily be physical or sexual.
This phase is a transformation from being an independent adult to having a vulnerable being depending on you. You can talk about your experience, feeling towards the baby and each other. Use this experience to bond even further with one another. Don’t expect too much of your sex life and don’t think you have to go back to your sex life within 6 weeks (as stated in many text books). Everyone is different. During the whole 9 months of pregnancy a woman’s body will go through a whole lot of hormonal changes these will take time to go back to where they were before pregnancy. The birth itself could be a very different experience from one person to another. Therefore, the couple should communicate well, express their needs and wants from one another and make sure they accommodate them as best as they can. Sometimes this means that you need to learn how to be sexual all over again. Especially if the mother has had a difficult birth experience.
5. With all the demands couples have to deal with (work, raising children, aging parents, etc), how can they learn to focus on building rich sexual lives? What key factors do they need to implement to make this happen?
The first and most important factor is that you have to have very strong time management skills. The second one, is that you have to be committed and make time. Sometimes you need to schedule a session in order to make sure you will have sex with your partner on a regular basis (this to be defined by the couple mutually). Third, you need to work on your skills to make clear boundaries and make priorities. Usually parents feel guilty if they make time for themselves especially to be intimate with one another but they are missing a very important point here. Children will learn from you, as how to make boundaries and how to make a couple’s relationship strong. If you don’t make time for yourselves as a couple they would not have a helpful role models to follow. They have to learn about the full-circled relationship of a couple which for many includes sex too. Usually couples who don’t follow these rules will end up in boring or frustrating relationships where sex is not fulfilling for one or both.
About Dr. Sara Nasserzadeh, MSc, DipPST, GCert, PhD: Sara-Nasserzadeh.com
Dr. Sara an accredited psychosexual therapist by the British Association for Sex and Relationship Therapists (BASRT) and a certified sexuality counselor by the American Association for Sexuality Educators, Counselors and Therapists (AASECT). She studied at Middlesex University, Relate Institute and University of East London in England. She is specialized in social psychology and policy and psychosexual therapy. She is the co-author of Orgasm Answer Guide published by the Johns Hopkins University Press (2009) and is in private practice in Manhattan. She is a member of the Executive Committee and the Associate secretary for the North America at the World Association for Sexual Health and chairs the Middle Eastern Sexual Health Committee at WAS. Her radio talk show for the BBC World Service has won the award for the innovation of the year in 2007. Dr.Sara is a regular commentator in media across the world. She has traveled and worked in 15 different counties and lectures widely for the public and health care professionals on sexual health/wellbeing, couple’s relationship, young people and sexuality, love and chemistry and culture and religion.
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